ne must take into consideration a stark difference between the Native and Western cultures. Regarding psychotherapy and the treatment of the mentally ill, one must proceed with the understanding that mental illness is not as common to Native Americans as it is to the modern Western culture. The stresses of contemporary society are alien to Indian cultures, and writers have been aware of this state of affairs since the early 17th century:
But what also helps them much to keep in health is the harmony that prevails among them. They have no lawsuits and take little pains to acquire the goods of this life, for which we Christians torment ourselves so much, and for our excessive and insatiable greed in acquiring them we are justly and with reason reproved by their quiet life and tranquil dispositions (Vogel 188).
One might also ask whether mental illness, per se, exists in primitive cultures at all. One may easily dismiss shamans as madmen. Determining whether or not those they treat have a disproportionately low percentage of mental illness is not easy. One problem is that studies which purport to measure instances of mental illness in primitive cultures have been conducted after the culture has adapted to Western life. Do studies that show mental illness in primitive cultures only reflect a response to Western culture itself?
Shamanistic healing operates in two paradigms. A shaman may determine that something is present in the ill person's body that must be removed. The shaman may also determine that something is missing from the ill person and that what is missing must be returned. The missing "item" is occasionally referred to as the patient's soul, and so when a shaman must return a patient's lost soul, the shaman must undertake a voyage to the other world. This is done in cases when subjects are suicidal, in other words, exhibiting signs of mental illness. The causes of "sou
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